Subarachnoid haemorrhage 1B Flashcards
What is the typical presentation in SAH and what is the timeline
a thunderclap headache that peaks within 1-5 minutes and last >1hr
What other typical symptoms are seen
sentinel headache which is milder days to weeks preceeding, vomiting, seizures, collapse and loss of consciousness
The most pathological cause of SAH is ?
a rupture of a berry (aka saccular) aneurysm in the circle of Willis
Peak onset of SAH is between what age range?
Peak onset is 40-60 years old.
One classical sign which can be seen in SAH after 6hrs is
kernig’s sign and other signs of meningism e.g. stiff neck
A risk factor that causes arteriovenous malformation is
autosomal dominant polycystic kidney disease
Between lupus, Ehlers Danlos and Marfan’s. which ones are risk factors for SAH
Ehlers Danlos and Marfan’s.
A clotting profile investigation may show what which points towards SAH
coagulopathy
U&E may show derangement of which electrolyte and why
hyponatraemia due to cerebral salt wasting
SAH can cause cardiac abnormalities
long QT
When is Non-contrast CT most sensitive for in the diagnosis of SAH
first 6 hours
When can a lumber puncture be done
after 12 hours if CT is negative
Why is an LP done at this time
Allows time for development of xanthochromia.
What is xanthochromia
a yellowing of the CSF from Hb breakdown.
How is xanthochromia detected
spectophotmetry of last (of 4) CSF bottles as there may be RBCs from first bottles due to traumatic tap
